Characterization of the inspiratory manoeuvre when asthmatics inhale through a Turbohaler pre- and post-counselling in a community pharmacy

Dose emission from a Turbohaler(R) has been shown to be dependent on the ra te of inhalation, with an optimal flow of 60 l min(-1) recommended. Some pa tients may need counselling to achieve this fast inhalation. Inhalation rat e profiles of 24 asthmatics were measured when they inhaled through a place bo Turbohaler(R). The setting was a community pharmacy when the asthmatics came to collect their next supply of medication. Profiles were measured bef ore and after counselling on how to use the Turbohaler. The mean (SD) peak inhalation rate through the Turbohaler pre- and post-counselling was 48.0 ( 16.8) and 547 (17.6) l min(-1), and their inspiratory volume was 1.75 (0.68 ) and 1.94 (0.62) l, respectively. Their mean (SD) percent predicted FEVI w as 57.0 (18.9)%. After counselling, 12 patients achieved an inhalation rate of > 60 l min(-1) and a further four obtained > 55 l min(-1). Emphasis sho uld be placed on counselling patients prescribed all types of inhaled devic es rather than concentrating on metered dose inhalers.